2023-05-242022/23:SoU13 · p.19SoUHealth & social services
Other matters concerning gender identity
Gender-affirming care for children and young people with gender dysphoria
What's at stake: The decision concerns how care for children and young people with gender dysphoria is designed, including whether surgical procedures and hormone treatment should be limited by an age threshold and whether talk therapy should be prioritised as a first-line intervention.
Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.
What the vote decides
The question is whether parliament should take its own initiative on gender-affirming care for children and young people with gender dysphoria - such as an age limit for surgical procedures and hormone treatment and greater emphasis on talk therapy - or whether the existing knowledge guidance from the responsible authority should be sufficient without a further parliamentary initiative.
Yes Yes — the committee proposal
The committee rejects the motions. The committee notes that the National Board of Health and Welfare has recently published national knowledge guidance on the care of children and young people with gender dysphoria, and considers that there is no reason for parliament to take its own initiative on the matter.
No No — the reservations
Reservation 29 (SD)
The reservation (SD) wants the government to ensure that surgical procedures and hormone treatment for gender dysphoria are not carried out on people under the age of 25, that gender-affirming care in Sweden is reviewed, and that talk therapy and psychological assessment are prioritised as the primary interventions in treatment.
Summarised from the committee report. Party labels in the summary come from the report, not from the vote.
What do the votes mean here?
Yes The committee proposal: rejecting the motions (keeping things as they are).
No Backing the counter-proposal: reservation 29 by SD.
Abstain The party marks a position of its own that is not one of the two final alternatives.
What each plan points to — and how the party voted
For each party: the vote its own election manifesto and party programme point to in this case, next to how the party actually voted. A plan can only point to Yes or No; a party can also abstain.
| Plan | Vote | Confidence | Evidence | ||
|---|---|---|---|---|---|
| V | Yes | Yes 18/0/0/6 | follows the plan | confidence: medium | derived |
| S | Yes | Yes 93/0/0/14 | follows the plan | confidence: medium | not addressed |
| MP | Yes | Abstain 0/0/13/5 | departs from the plan | confidence: high | not addressed |
| C | Yes | Yes 21/0/0/3 | follows the plan | confidence: medium | not addressed |
| L | Yes | Yes 11/0/0/5 | follows the plan | confidence: medium | not addressed |
| KD | No | Yes 14/0/0/5 | departs from the plan | confidence: medium | not addressed |
| M | Yes | Yes 59/0/0/9 | follows the plan | confidence: low | not addressed |
| SD | No | No 0/63/0/9 | follows the plan | confidence: high | explicit |
Committee proposal
Parliament rejects the motions 2022/23:253 by Angelica Lundberg (SD), 2022/23:542 by Alexander Christiansson and Markus Wiechel (both SD) points 1 and 2, 2022/23:756 by Ulrika Westerlund et al. (MP) points 1, 3 and 4, 2022/23:1141 by Linda Lindberg et al. (SD) points 9-11 and 2022/23:2047 by Mikael Oscarsson (KD) points 1, 2 and 4.
Original (Swedish)
Riksdagen avslår motionerna 2022/23:253 av Angelica Lundberg (SD), 2022/23:542 av Alexander Christiansson och Markus Wiechel (båda SD) yrkandena 1 och 2, 2022/23:756 av Ulrika Westerlund m.fl. (MP) yrkandena 1, 3 och 4, 2022/23:1141 av Linda Lindberg m.fl. (SD) yrkandena 9-11 och 2022/23:2047 av Mikael Oscarsson (KD) yrkandena 1, 2 och 4.
Riksdag decision: Parliament directs a formal request (tillkännagivande) to the government to develop a national action and coordination plan for rare diseases. Parliament considers that a coordinated approach to care and support for patients with rare diseases is necessary, as these patients may wait a long time for diagnosis and thus treatment and follow-up. The formal request came in connection with the committee handling motions submitted during the general motion period 2022. Parliament rejected other motions concerning priorities in healthcare. Parliament considers, among other things, that work is already underway in the areas addressed by the motions.
Counter-proposals
- The counter-proposal wants the government to consider diabetes care in its work toward fair healthcare, establish a national action plan for long-covid, and investigate the causes of women's high sick leave. (SD) — Reservation 29
Plan vs actual vote
Every party, in chamber order: what its own plan pointed to, how it voted, and the reasoning behind both. Highlighted rows are where the two differ — but a vote that follows the plan is a result too, so the reasoning is there for every party.
The party programme accepts no special treatment of trans persons and makes LGBTQ persons' rights an obvious part of the party's feminist struggle; it explicitly attacks society's organization around two fixed sexes.
Plan documents: party programme
Reasoning and quotes
The party programme accepts no special treatment of trans persons and makes LGBTQ persons' rights an obvious part of the party's feminist struggle; it explicitly attacks society's organization around two fixed sexes. The counter-proposal instead wants to introduce a 25-year age limit for surgery and hormone treatment and make talk therapy the primary intervention, which restricts gender-affirming care. This conflicts with the plan's demands for increased knowledge and equal treatment in healthcare.
Original (Swedish)
Partiprogrammet accepterar ingen särbehandling av transpersoner och gör hbtq-personers rättigheter till en självklar del av partiets feministiska kamp; det angriper uttryckligen samhällets organisering kring två fasta kön. Motförslaget vill i stället införa en 25-årsgräns för kirurgi och hormonbehandling och göra samtalsterapi till primär insats, vilket inskränker den könsbekräftande vården. Det strider mot planens krav på ökad kunskap och likabehandling i vården.
- no special treatment of trans personsdecisive»Ingen diskriminering eller särbehandling av homosexuella, bisexuella, transpersoner och queer-personer« (party programme ↗)“No discrimination or special treatment of homosexual, bisexual, trans persons and queer persons.”
- increased LGBTQ knowledge in healthcare»Inom utbildning, vård, näringsliv och rättsväsende måste kunskaperna i hbtq-frågor öka.« (party programme ↗)“Within education, healthcare, business and the legal system, knowledge in LGBTQ issues must increase.”
- trans persons' vulnerability»Särskilt för transpersoner, både de som avviker från« (party programme ↗)“Particularly for trans persons, both those who deviate from”
- LGBTQ rights as feminism»rättigheter och en självklar del i Vänsterpartiets feministiska kamp« (party programme ↗)“rights and an obvious part of the Left Party's feminist struggle.”
The plan's goal is a society without homophobia and transphobia and that people shall be free to determine their own lives, while welfare services shall be distributed according to need.
Plan documents: party programme
Reasoning and quotes
The plan's goal is a society without homophobia and transphobia and that people shall be free to determine their own lives, while welfare services shall be distributed according to need. A general age limit of 25 years for surgery and hormone treatment for gender dysphoria, with counselling as the primary intervention, restricts both individual self-determination and the needs principle in healthcare. The plan therefore speaks against the counter-proposal's demand.
Original (Swedish)
Planens mål är ett samhälle utan homo- och transfobi och att människan ska vara fri att råda över sitt eget liv, medan välfärdens tjänster ska fördelas efter behov. En generell åldersgräns på 25 år för kirurgi och hormonbehandling vid könsdysfori, med samtalsterapi som primär insats, inskränker både den enskildes självbestämmande och behovsprincipen i vården. Planen talar därför mot motförslagets krav.
- society without transphobiadecisive»klasskillnader, patriarkat, rasism eller homo- och transfobi« (party programme ↗)“class differences, patriarchy, racism or homophobia and transphobia”
- determine one's own life»Människan ska vara fri att utvecklas som individ, råda över sitt eget liv, forma sin tillvaro« (party programme ↗)“People shall be free to develop as individuals, determine their own lives, shape their existence”
- care according to need»välfärdstjänsterna fördelas efter behov.« (party programme ↗)“welfare services are distributed according to need.”
The election manifesto wants to strengthen transgender people's rights through a new gender recognition law, while the counter-proposal wants to prohibit surgery and hormone treatment for everyone under 25 years and make talk therapy the primary intervention.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto wants to strengthen transgender people's rights through a new gender recognition law, while the counter-proposal wants to prohibit surgery and hormone treatment for everyone under 25 years and make talk therapy the primary intervention. The party programme's principle that every person has the right to define themselves and on patient self-determination speaks against such a general age limit. The plan therefore rejects the demand.
Original (Swedish)
Valmanifestet vill stärka transpersoners rättigheter genom en ny könstillhörighetslag, medan motförslaget vill förbjuda kirurgi och hormonbehandling för alla under 25 år och göra samtalsterapi till primär insats. Partiprogrammets princip om varje människas rätt att definiera sig själv och om patientens självbestämmande talar mot en sådan generell åldersgräns. Planen avvisar därför kravet.
- strengthened transgender rightsdecisive»stärka transpersoners rättigheter genom en ny könstillhörighetslag, och införa ett tredje juridiskt kön.« (2022 manifesto ↗)“strengthen transgender people's rights through a new gender recognition law, and introduce a third legal gender.”
- right to define oneself»Varje människa har rätt att vara och växa till den« (party programme ↗)“Every person has the right to be and grow to the”
- equal rights regardless of gender identity»Alla ska åtnjuta lika rättigheter och möjligheter« (party programme ↗)“Everyone should enjoy equal rights and opportunities”
- patient self-determination»Patientens självbestämmande och delaktighet är en« (party programme ↗)“Patient self-determination and participation is a”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan is founded on the individual's right to form their own life, the right to create their own identity and freedom from paternalism, and that healthcare shall be based on science and proven experience.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan is founded on the individual's right to form their own life, the right to create their own identity and freedom from paternalism, and that healthcare shall be based on science and proven experience. The counter-proposal requires a general age limit at 25 years and that talking therapy shall be prioritized, thus political determination of healthcare's medical assessments. The plan speaks against this, even though gender dysphoria care is not treated explicitly.
Original (Swedish)
Planen bygger på individens rätt att forma sitt eget liv, rätten att skapa sin egen identitet och frihet från förmynderi, samt att vården ska baseras på vetenskap och beprövad erfarenhet. Motförslaget kräver en generell åldersgräns vid 25 år och att samtalsterapi ska prioriteras, alltså ett politiskt fastställt förmynderi över vårdens medicinska bedömningar. Det talar planen emot, även om könsdysforivård inte behandlas uttryckligen.
- healthcare on scientific groundsdecisive»God vård och omsorg i hela landet, baserad på vetenskap och beprövad erfarenhet« (party programme ↗)“Good healthcare and care throughout the country, based on science and proven experience”
- the right to form one's life»Centerpartiet kommer alltid försvara din rätt att forma ditt eget liv.« (2022 manifesto ↗)“The Centre Party will always defend your right to form your own life.”
- right to own identity»Varje individ har rätt att skapa sin egen identitet.« (party programme ↗)“Every individual has the right to create their own identity.”
- freedom from paternalism»vi försvarar alla människors frihet från förmynderi« (party programme ↗)“we defend all people's freedom from paternalism”
The plan frames the LGBTQI issue as a freedom issue and wants to strengthen LGBTQI competence in healthcare, not restrict access to gender-affirming care.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan frames the LGBTQI issue as a freedom issue and wants to strengthen LGBTQI competence in healthcare, not restrict access to gender-affirming care. A general age limit at 25 and steering towards conversation therapy as a primary measure conflicts with the plan's requirement that care be provided on a scientific basis and based on patient participation. The counter-proposal's demands are therefore rejected by the plan.
Original (Swedish)
Planen gör hbtqi-frågan till en frihetsfråga och vill stärka hbtqi-kompetensen i vården, inte begränsa tillgången till könsbekräftande vård. En generell åldersgräns vid 25 år och en styrning mot samtalsterapi som primär insats strider mot planens krav på att vården ges på vetenskaplig grund och utifrån patientens egen delaktighet. Motförslagets krav avvisas därför av planen.
- LGBTQI reforms as freedom issuedecisive»Hbtqi-reformer handlar om frihet. Sverige ska vara världens bästa land att leva i som hbtqi-person.« (2022 manifesto ↗)“LGBTQI reforms are about freedom. Sweden shall be the world's best country to live in as an LGBTQI person.”
- care on scientific basis»Vård, behandling och rehabilitering av fysiska och psykiska sjukdomar ska ges på vetenskaplig grund.« (party programme ↗)“Care, treatment and rehabilitation of physical and mental illnesses shall be provided on a scientific basis.”
- patient self-determination»Patienten ska ha rätt att vara delaktig i utformningen av den egna vården« (party programme ↗)“The patient shall have the right to be participant in the design of their own care”
- strengthened LGBTQI competence in healthcare»Hbtqi-kompetensen i vård, skola och omsorg ska stärkas och ett lagskydd mot omvändelseterapi ska införas.« (2022 manifesto ↗)“LGBTQI competence in healthcare, school and care shall be strengthened and legal protection against conversion therapy shall be introduced.”
The plan requires that care is safe for patients and based on knowledge and proven experience, and that the child's best interests come first.
Plan documents: party programme
Reasoning and quotes
The plan requires that care is safe for patients and based on knowledge and proven experience, and that the child's best interests come first. It also requires that the principle of human dignity marks frameworks and practice in the medical ethical field and that children and young people with mental ill-health quickly get accessible expertise. Age limit for irreversible procedures, review of care and psychological examination as primary intervention follow from these commitments.
Original (Swedish)
Planen kräver att vården är säker för patienterna och baserad på kunskap och beprövad erfarenhet, och att barnets bästa kommer i främsta rummet. Den kräver också att människovärdesprincipen präglar ramar och praktik inom det medicinsketiska området och att barn och unga med psykisk ohälsa snabbt får tillgänglig kompetens. Åldersgräns för irreversibla ingrepp, granskning av vården och psykologisk utredning som primär insats följer av dessa åtaganden.
- evidence-based caredecisive»baserad på kunskap och beprövad erfarenhet, det vill säga evidensbaserad.« (party programme ↗)“based on knowledge and proven experience, that is to say evidence-based.”
- child's best interests first»barnets bästa ska komma i främsta rummet.« (party programme ↗)“the child's best interests shall come first.”
- human dignity guides medical ethics»Alla människors absoluta och okränkbara värde ska därför prägla ramar, regler och praktik inom det medicinsketiska området.« (party programme ↗)“All people's absolute and inviolable value shall therefore mark frameworks, rules and practice within the medical ethical field.”
- mental ill-health in young people»Särskild vikt ska läggas vid snabb och tillgänglig kompetens för barn och ungdom med psykisk ohälsa.« (party programme ↗)“Special emphasis shall be placed on quick and accessible expertise for children and young people with mental ill-health.”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan does not address gender dysphoria care, but takes a position for LGBTQ persons' right to live freely and wants to prohibit therapy aimed at changing an individual's sexual orientation or gender identity.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan does not address gender dysphoria care, but takes a position for LGBTQ persons' right to live freely and wants to prohibit therapy aimed at changing an individual's sexual orientation or gender identity. The counter-proposal's demand for an age limit at 25 years and for talking therapy as primary intervention goes against both that prohibition and the principle that adults make life's important decisions. The evidence is weak, so certainty is low.
Original (Swedish)
Planen behandlar inte könsdysforivården, men den tar ställning för hbtq-personers rätt att leva fritt och vill förbjuda terapi som syftar till att ändra en individs sexuella läggning eller könsidentitet. Motförslagets krav på en åldersgräns vid 25 år och på samtalsterapi som primär insats går emot både det förbudet och principen att vuxna själva fattar livets viktiga beslut. Underlaget är svagt, varför säkerheten är låg.
- prohibition on conversion therapydecisive»Förbjuda konverteringsterapi, som syftar till att ändra en individs sexuella läggning eller könsidentitet« (2022 manifesto ↗)“Prohibit conversion therapy, aimed at changing an individual's sexual orientation or gender identity”
- LGBTQ persons' rights»I Sverige ska du kunna leva ett fritt liv, och öppet kunna visa din kärlek, bilda familj och få ett tryggt bemötande av det offentliga, oavsett vilken sexuell läggning du har.« (2022 manifesto ↗)“In Sweden you shall be able to live a free life, and openly show your love, start a family and get safe treatment from the public sector, regardless of what sexual orientation you have.”
- adults make own decisions»Där medborgarna tillåts vara vuxna« (party programme ↗)“Where citizens are allowed to be adults”
- tolerance for life choices»Toleransen handlar om öppenhet för människors olika vägar« (party programme ↗)“Tolerance is about openness for people's different paths”
The election manifesto points out hormone treatment to alter children's natural puberty and surgical sex change procedures as particularly serious and requires that society's handling of children with gender dysphoria and its long-term consequences be investigated.
Plan documents: 2022 manifesto
Reasoning and quotes
The election manifesto points out hormone treatment to alter children's natural puberty and surgical sex change procedures as particularly serious and requires that society's handling of children with gender dysphoria and its long-term consequences be investigated. The counter-proposal's requirements for age limit for procedures and hormone treatment, review of gender-affirming care and psychotherapy as primary intervention are precisely that direction. The plan also emphasizes that effective treatment measures such as psychotherapy should be offered to a greater degree.
Original (Swedish)
Valmanifestet pekar ut hormonbehandling för att ändra barns naturliga pubertet och kirurgiska könsbytesingrepp som särskilt allvarliga och kräver att samhällets hantering av barn med könsdysfori och dess långsiktiga konsekvenser utreds. Motförslagets krav på åldersgräns för ingrepp och hormonbehandling, granskning av den könsbekräftande vården och samtalsterapi som primär insats är just den linjen. Planen betonar dessutom att effektiva behandlingsåtgärder som samtalsterapi bör erbjudas i högre grad.
- restrictive view on sex proceduresdecisive»Särskilt allvarlig är användning av hormonbehandling för att ändra barns naturliga pubertet och kirurgiska ingrepp för att ”byta kön”.« (2022 manifesto ↗)“Particularly serious is the use of hormone treatment to alter children's natural puberty and surgical procedures to 'change sex'.”
- scrutinize gender dysphoria care»Samhällets hantering av barn med könsdysfori och dess långsiktiga konsekvenser ska utredas.« (2022 manifesto ↗)“Society's handling of children with gender dysphoria and its long-term consequences shall be investigated.”
- psychotherapy as intervention»Effektiva behandlingsåtgärder, i form av exempelvis samtalsterapi, bör i högre grad erbjudas« (2022 manifesto ↗)“Effective treatment measures, in the form of for example psychotherapy, should to a greater degree be offered”
- stop experiments on young people»Avsluta de politiska experimenten på Sveriges barn och unga« (2022 manifesto ↗)“End the political experiments on Sweden's children and youth”
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Sources and documents
- The committee report on riksdagen.se (2022/23:SoU13)
- Committee report full text (HA01SoU13)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2022/23:1134 — Förbud mot icke-medicinsk omskärelse av Richard Jomshof (SD)
- Motion 2022/23:1141 — En tillgänglig sjukvård i världsklass av Linda Lindberg m.fl. (SD)
- Motion 2022/23:1151 — En trygg och human sjukförsäkring med individen i centrum av Clara Aranda m.fl. (SD)
- Motion 2022/23:1234 — En hälso- och sjukvård för jämlikhet och jämställdhet i hela landet av Nooshi Dadgostar m.fl. (V)
- Motion 2022/23:1259 — Självbestämmande i livets slutskede - utred förutsättningarna för aktiv dödshjälp av Janine Alm Ericson m.fl. (MP)
- Motion 2022/23:1291 — Borttagande av den övre åldersgränsen för mammografi av Sanna Backeskog och Jim Svensk Larm (båda S)
- Motion 2022/23:1301 — Regelverk kring blodgivning av Inga-Lill Sjöblom m.fl. (S)
- Motion 2022/23:1305 — Forskning om och behandling av lipödem av Marianne Fundahn (S)
- Motion 2022/23:1309 — Nationella riktlinjer för förlossningsvården av Alexandra Völker (S)
- Motion 2022/23:131 — Stöd vid missfall av Anna Wallentheim (S)
- Motion 2022/23:1310 — Samordnad vård för personer med sällsynta hälsotillstånd av Alexandra Völker (S)
- Motion 2022/23:1312 — Rätten till abort av Mathias Tegnér (S)
- Motion 2022/23:1324 — Nationella riktlinjer för vård och behandling av barn och unga vid psykisk ohälsa av Alexandra Völker (S)
- Motion 2022/23:1329 — Ätstörningsvården av Anna Wallentheim (S)
- Motion 2022/23:134 — Anmälan till donationsregistret via deklarationen av Louise Meijer (M)
- Motion 2022/23:135 — Införande av aktiv dödshjälp av Louise Meijer (M)
- Motion 2022/23:1358 — Stärkt förlossningsvård av Sanne Lennström och Sofia Skönnbrink (båda S)
- Motion 2022/23:1361 — Åtgärder för att förhindra utbredning av livmoderhalscancer av Sanne Lennström och Sofia Skönnbrink (båda S)
- Motion 2022/23:1372 — Regnbågsblod av Anna Wallentheim (S)
- Motion 2022/23:1433 — Slopad övre åldersgräns för cellprovtagning och mammografi av Louise Thunström och Sofia Skönnbrink (båda S)
Source: The Swedish Parliament